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Background: The importance of social networking sites (SNSs) as platforms to engage in the correction of "fake news" has been documented widely. More evidence is needed to understand the popularity of health-related rumors and how Health Educators can optimize their use of SNSs. Purpose: The purpose of this study was to explore the spread of health rumors and verified information on SNSs using the Zika virus as a case study. Methods: A content analysis of Zika-related news stories on SNSs between February 2016 and January 2017 was conducted to verify accuracy (phase 1). Phase 1 was followed by an analysis of volume of shares (phase 2) and a thematic analysis of headlines (phase 3). Results: Rumors had three times more shares than verified stories. Popular rumors portray Zika as a conspiracy against the public and a low-risk issue and connect it to the use of pesticides. Discussion: This study identifies the value of integrating in-depth analysis of popular health-related rumors into the development of communication strategies. Translation to Health Education Practice: Misinformation on SNSs can hinder disease prevention efforts. This study shows how information circulating on SNSs can be analyzed from a quantitative and qualitative standpoint to help Health Educators maximize the use of online communication platforms.

Objective: There is a dearth of literature describing young adult (YA) cancer survivors' experiences with cancer‐related cognitive impairment (CRCI). We aimed to elucidate CRCI among YA cancer survivors and identify potentially modifiable risk factors. Methods: We conducted individual qualitative interviews with YA cancer survivors aged 18–30 years at study enrollment and used applied thematic analysis to identify themes across three topics (i.e., affected cognitive abilities, risk and protective factors influencing the impact of CRCI, and strategies for coping with CRCI). Results: YA cancer survivors (N = 20) were, on average, 23 years old at diagnosis and 26 years old when interviewed. Diverse cancer types and treatments were represented; most participants (85%) had completed cancer treatment. Participants described experiences across three qualitative topics: (1) affected cognitive abilities (i.e., concentration and attention, prospective memory, and long‐term memory), (2) Risk factors (i.e., fatigue, sleep problems, mood, stress/distractions, and social isolation) and protective factors (i.e., social support), and (3) coping strategies, including practical strategies that helped build self‐efficacy (e.g., writing things down, reducing distractions), beneficial emotion‐focused coping strategies (e.g., focus on health, faith/religion), strategies with mixed effects (i.e., apps/games, medications/supplements, and yoga), and "powering through" strategies that exacerbated stress. Conclusions: YA cancer survivors experience enduring cognitive difficulties after treatment. Specific concerns highlight the importance of attention and executive functioning impairments, long‐term memory recall, and sensitivity to distractions. Future work is needed to improve assessment and treatment of CRCI among YA cancer survivors. [ABSTRACT FROM AUTHOR]

Cultural norms shape expectations, care, and communication. Effective interpersonal communication is a prominent predictor of patient-partner cancer management, improving the overall quality of life for the dyad by increasing their ability to cope with cancer. However, couples-based cancer interventions often do not consider cultural factors. Additionally, although Latinas have a high incidence of breast cancer, few studies focus on Latino couples and the influence of culture in cancer care interventions. This study focuses on understanding how Latino culture's norms and expectations influence how couples communicate and cope post-breast cancer diagnosis. This study conducted interviews and focus groups with a purposive sample of Spanish-speaking Latina breast cancer survivors (N = 21) and intimate partners (N = 5). In the focus group and interviews, participants were asked about the influence cancer had on their relationship, with specific questions focusing on communication within the dyad. The study team used CARV: Community-Engaged Adaptation with Rapid Analysis and Visualization framework to identify cultural considerations and recurring themes. The cross-cutting cultural considerations and themes found were: the negative influence of gendered and social norms on managing emotions and coping; the silent struggle with physical intimacy; and the inability to discuss the topic – or even say the word 'cancer.' Understanding the role of Latino culture in how couples cope with and communicate about cancer post-diagnosis is essential. This understanding will help strengthen the dyad by assisting with positive interpersonal support, which contributes to a better quality of life. These findings will also help providers assist dyads in navigating the cancer diagnosis and journey, helping to lessen the interpersonal stress and tensions that can occur after diagnosis. [ABSTRACT FROM AUTHOR]

The COVID-19 pandemic profoundly impacted psychological well-being worldwide. Oncology health care professionals' (OHCPs') perceptions of psychological effects of COVID-19 among people in active cancer treatment were explored. Semi-structured interviews with a purposive sample of OHCPs actively providing care were conducted. Interviews were audio-recorded, transcribed, and coded using Atlas.ti v8 and thematic analysis. In total, 30 OHCPs participated. Most were registered nurses (70%), worked in outpatient setting (56.7%) and were in their current position 1–5 years (53.3%). Overarching themes are as follows: (a) cancer treatment disrupted due to patients' fear of exposure to COVID-19; (b) social distancing restrictions caused discontinued social support and supportive services that exacerbated psychological distress; (c) pandemic-related stressors led to overwhelmed coping skills; and (d) OHCPs played a vital role in providing emotional support and connecting patients with family/friends through technology. Behavioral health interventions should focus within the "new world of COVID-19" of reduced face-to-face support and increased online support for patients. [ABSTRACT FROM AUTHOR]

Perceptions of oncology health care providers use of telehealth to provide care to patients during the COVID-19 pandemic were explored. A qualitative study using semi-structured interviews and purposive sampling (N = 30) was conducted. Four themes emerged: 1) telehealth provided continuity of cancer care and used to decrease the risk of COVID-19 exposure; 2) advantages brought about convenience and inclusion of family caregivers; 3) telehealth revealed geographic, aging, and racial/ethnic disparities and digital illiteracy; and 4) rapid implementation was challenging. Telehealth provides a number of opportunities to support care for vulnerable cancer patients during this health crisis; however, disparities must be addressed. [ABSTRACT FROM AUTHOR]

The Hispanic/Latino population is the second largest racial/ethnic group in the continental United States and Hawaii, accounting for 18% (60.6 million) of the total population. An additional 3 million Hispanic Americans live in Puerto Rico. Every 3 years, the American Cancer Society reports on cancer occurrence, risk factors, and screening for Hispanic individuals in the United States using the most recent population‐based data. An estimated 176,600 new cancer cases and 46,500 cancer deaths will occur among Hispanic individuals in the continental United States and Hawaii in 2021. Compared to non‐Hispanic Whites (NHWs), Hispanic men and women had 25%‐30% lower incidence (2014‐2018) and mortality (2015‐2019) rates for all cancers combined and lower rates for the most common cancers, although this gap is diminishing. For example, the colorectal cancer (CRC) incidence rate ratio for Hispanic compared with NHW individuals narrowed from 0.75 (95% CI, 0.73‐0.78) in 1995 to 0.91 (95% CI, 0.89‐0.93) in 2018, reflecting delayed declines in CRC rates among Hispanic individuals in part because of slower uptake of screening. In contrast, Hispanic individuals have higher rates of infection‐related cancers, including approximately two‐fold higher incidence of liver and stomach cancer. Cervical cancer incidence is 32% higher among Hispanic women in the continental US and Hawaii and 78% higher among women in Puerto Rico compared to NHW women, yet is largely preventable through screening. Less access to care may be similarly reflected in the low prevalence of localized‐stage breast cancer among Hispanic women, 59% versus 67% among NHW women. Evidence‐based strategies for decreasing the cancer burden among the Hispanic population include the use of culturally appropriate lay health advisors and patient navigators and targeted, community‐based intervention programs to facilitate access to screening and promote healthy behaviors. In addition, the impact of the COVID‐19 pandemic on cancer trends and disparities in the Hispanic population should be closely monitored. [ABSTRACT FROM AUTHOR]

Aim: To explore oncology health care professionals' perceptions of the COVID‐19 pandemic response. Background: The pandemic has created health care delivery challenges globally and many countries have exhibited low readiness and emergency preparedness. Methods: A descriptive design using a qualitative approach was employed. Semi‐structured interviews, which were completed via telephone, were audio recorded and transcribed verbatim. A thematic analysis was conducted. Results Participants (N = 30) were mostly registered nurses (70%). Three themes emerged: (1) ability to adapt and operationalize disaster planning, training and restructure nursing models (subtheme: reactive vs. proactive approach to emergency preparedness); (2) COVID‐19 task forces and professional organisations were critical for valid information surrounding the pandemic; and (3) recommendations for emergency preparedness/planning for future pandemics. Conclusion: Oncology organisations adapted during the pandemic, but policies and procedures were perceived as reactive and not proactive. Recommendations for planning for future pandemics included (1) adequate personal protective equipment, (2) developing cancer‐specific guidelines/algorithms and (3) telehealth training related to billing/reimbursement. Professional organisations were reliable resources of information during the pandemic, but oncology professionals ultimately trusted employers and administration to distribute information needed for safe patient care. Implications for nursing management: Frontline nurses should hold positions on task forces to develop future emergency preparedness. [ABSTRACT FROM AUTHOR]

Background: Cyclin‐dependent kinase 4 and 6 (CDK4/6) inhibitor targeted therapies dramatically improve survival outcomes for metastatic breast cancer (MBC), but they are associated with significant symptom burden that can impact patients' health‐related quality of life (HRQOL) and treatment outcomes. This study is the first to describe CDK4/6 inhibitor symptoms from the lived perspectives of MBC patients taking CDK4/6 inhibitors and healthcare providers involved in MBC care. This study also explored patients' symptom management and HRQOL concerns, and gathered feedback about developing supportive interventions for MBC. Methods: MBC patients taking CDK4/6 inhibitors (N = 20) and MBC healthcare providers (N = 12) participated in semi‐structured interviews that were analyzed for qualitative themes. MBC patients completed surveys about HRQOL, symptoms, and unmet needs. Results: Patient and provider perceptions of CDK4/6 inhibitor symptoms did not align with patients perceiving symptoms as more burdensome. Patients reported that supportive resources (e.g., support groups, blogs) that are not specific to MBC do not adequately meet their needs. Patients and providers were enthusiastic about developing supportive interventions specifically for MBC and offered considerations for designing such interventions. Conclusions: Findings highlight differences in perceptions of CDK4/6 inhibitor symptom burden between MBC patients and providers. Results will inform the development of supportive interventions to assist MBC patients in managing CDK4/6 inhibitor symptom burden and maintaining HRQOL. Such interventions could also improve treatment outcomes. Metastatic breast cancer (MBC) patient and provider perceptions of symptoms associated with CDK4/6 inhibitor did not align, with patients perceiving symptoms as more burdensome. Patients reported that supportive resources (e.g., support groups, blogs) that are not specific to MBC do not adequately meet their needs, however patients and providers were enthusiastic about developing supportive interventions specifically for MBC and offered considerations for designing such interventions. Results will inform the development of supportive interventions to assist MBC patients in managing CDK4/6 inhibitor symptom burden and maintaining health‐related quality of life. [ABSTRACT FROM AUTHOR]

Persistent human papillomavirus (HPV) infections can cause cancer (e.g., cervical/vaginal/penile/anal/oropharyngeal). The HPV vaccine prevents cancer, yet U.S. vaccination rates remain low. We explored sociopolitical factors in the adoption of Puerto Rico's HPV vaccine school-entry requirement. Multiple streams framework explains how the intersection of problems, policy, and politics streams influence policy adoption. Policy entrepreneurs work on joining these streams. Interviews (n = 20) were conducted with stakeholders (e.g., physicians/researchers/nonprofit organizations' leaders). Data were analyzed using applied thematic analysis. High incidence of HPV and HPV-related cancers in Puerto Rico were indicators of problems. Focusing events included Rhaiza's case and the HPV-Advisory Panel Report. During summer 2017, a policy window opened; the Department of Health (DOH) adopted the requirement in summer 2018. Stakeholders discussed policy initiatives. Political turnover positively influenced the process. Policy entrepreneurs created an extended period of intersection resulting in the adoption of the requirement. Findings can inform policy initiatives to improve HPV vaccination rates and reduce HPV-related cancers. [ABSTRACT FROM AUTHOR]

Introduction: There is a paucity of information on cancer among Indigenous populations in Latin America. Methods: Guided by tenets of community engaged research and syndemic theory, we conducted eight focus groups (n = 59) with Kichwa men and women in the province of Imbabura, Ecuador. Data were analyzed using applied thematic analysis techniques. Results: Cancer emerged as an important health problem and was reported as a growing concern. Kichwa participants in this study attributed the rise in cancer to (1) exposure to chemicals and pesticides, (2) urbanization and development, and (3) the rise of innutritious, westernized diets. Conclusion: Our findings suggest that the Kichwa are attuned to the global phenomena in which traditional diet has been replaced by western, processed foods and fast food, which result in higher levels of chronic diseases such as cancer. More research is needed to understand the cancer burden among Indigenous peoples in Latin America. [ABSTRACT FROM AUTHOR]

Objective: Colorectal cancer (CRC) screening efforts have effectively reduced CRC morbidity and mortality, yet screening remains relatively low among Latinos. The study's purpose was to document the awareness/knowledge of Fecal Immunochemical Test (FIT) among Latinos, gain better understanding of patient and health care provider perceptions about FIT, and explore the feasibility of adoption/uptake. Design/Methods: The study was guided by qualitative, ethnography design and methods. Eight focus groups (FG) with patients who self-identified as Hispanic/Latino between 50–75 years of age and key informant interviews with providers (N = 10) were conducted followed by a brief demographic questionnaire. Results: Awareness levels varied based on prior screening experiences among patients and providers. Both patients and providers believed the FIT is simple and easy to use; although, a minority of patients expressed doubts about the efficacy of the FIT when compared to colonoscopy. Conclusions: Despite the increasing acceptance of the FIT among the health care community, a significant lag time still exists among our study's populations. Study findings speak to novelty of the FIT test among underserved populations and the health disparity gap between health innovations/discoveries. Increased awareness and education efforts about the efficacy coupled with information about its accessibility, ease, and user instructions may increase the adoption of FIT. [ABSTRACT FROM AUTHOR]

Cancer is the leading cause of death among Hispanics/Latinos, who represent the largest racial/ethnic minority group in the United States, accounting for 17.8% (57.5 million) of the total population in the continental United States and Hawaii in 2016. In addition, more than 3 million Hispanic Americans live in the US territory of Puerto Rico. Every 3 years, the American Cancer Society reports on cancer occurrence, risk factors, and screening for Hispanics in the United States based on data from the National Cancer Institute, the North American Association of Central Cancer Registries, and the Centers for Disease Control and Prevention. For the first time, contemporary incidence and mortality rates for Puerto Rico, which has a 99% Hispanic population, are also presented. An estimated 149,100 new cancer cases and 42,700 cancer deaths will occur among Hispanics in the continental United States and Hawaii in 2018. For all cancers combined, Hispanics have 25% lower incidence and 30% lower mortality compared with non-Hispanic whites, although rates of infection-related cancers, such as liver, are up to twice as high in Hispanics. However, these aggregated data mask substantial heterogeneity within the Hispanic population because of variable cancer risk, as exemplified by the substantial differences in the cancer burden between island Puerto Ricans and other US Hispanics. For example, during 2011 to 2015, prostate cancer incidence rates in Puerto Rico (146.6 per 100,000) were 60% higher than those in other US Hispanics combined (91.6 per 100,000) and 44% higher than those in non-Hispanic whites (101.7 per 100,000). Prostate cancer is also the leading cause of cancer death among men in Puerto Rico, accounting for nearly 1 in 6 cancer deaths during 2011-2015, whereas lung cancer is the leading cause of cancer death among other US Hispanic men combined. Variations in cancer risk are driven by differences in exposure to cancer-causing infectious agents and behavioral risk factors as well as the prevalence of screening. Strategies for reducing cancer risk in Hispanic populations include targeted, culturally appropriate interventions for increasing the uptake of preventive services and reducing cancer risk factor prevalence, as well as additional funding for Puerto Rico-specific and subgroup-specific cancer research and surveillance. [ABSTRACT FROM AUTHOR]

Cancer survivors manage their new status using a multitude of coping mechanisms. Coping strategies vary by individual, but are also socioculturally mediated. Scarce evidence on coping strategies adopted by Hispanic male cancer survivors (HMCS) is available to date. The purpose of this study was to explore the reaction to diagnosis and subsequent coping strategies employed by HMCS. Data were gathered through focus groups (n = 18), cognitive interviews (n = 12), and phone interviews (n = 84). Coping strategies included positive attitudes, humor, optimism and social support, use of home remedies, lifestyle changes, and faith. Findings are consistent with research on non-cancer-related coping showing that HMCS use active coping strategies, such as religion and support from family and friends. The analysis of existing strategies and needs points to the need to develop evidence-based psychosocial services that build on strengths and coping behaviors already employed by HMCS. [ABSTRACT FROM AUTHOR]

In this “Tools From the Field” paper, we report our experiences using human-centered design (HCD), a process for using innovation as a means of developing more effective marketing offerings. The context for our use of HCD tools was a partnership with a new community committee. We combined elements of our previous social marketing frameworks -Community-Based Prevention Marketing (CBPM) for Program Development; CBPM for Policy Development–into a version better suited to address complex, dynamic problems that require a whole-systems perspective. Our product development work for this next iteration of the CBPM framework incorporated several HCD tools adapted from the prolific design firm, IDEO. The HCD process consists of three phases: inspiration (e.g., learning from those that one is designing for), ideation (e.g., brainstorming and prototyping), and implementation (e.g., building partnerships and launching a business model). In this paper, we describe “tools” for the application of HCD within the context of rapidly prototyping and testing CBPM framework activities for use with our community committee partners; we provide practical advice for the use of these tools (“process points”); and we present a real-world application from development of our new CBPM framework (“tools in action”). Overall, the HCD tools from IDEO helped us see new opportunities for our framework, transform insights into actionable ideas, and increase the speed of producing a minimum viable product and gathering feedback on it from our customers. We believe that HCD tools are worth exploring when it comes to the social marketing planning process. [ABSTRACT FROM AUTHOR]

Objective. Research with ethnic minority populations requires instrumentation that is cultural and linguistically relevant. The aim of this study was to translate and culturally adapt the Cancer Survivor Unmet Needs measure into Spanish. Methods. We describe the iterative, community-engaged consensus-building approaches used to adapt the instrument for Hispanic male cancer survivors. We used an exploratory sequential mixed method study design. Methods included translation and back-translation, focus groups with cancer survivors (n = 18) and providers (n = 5), use of cognitive interview techniques to evaluate the comprehension and acceptability of the adapted instrument with survivors (n = 12), ongoing input from the project's community advisory board, and preliminary psychometric analysis (n = 84). Results. The process emphasized conceptual, content, semantic, and technical equivalence. Combining qualitative and quantitative approaches offered a rigorous, systematic, and contextual approach to translation alone and supports the cultural adaptation of this measure in a purposeful and relevant manner. Conclusion. Our findings highlight the importance of going beyond translation when adapting measures for cross-cultural populations and illustrate the importance of taking culture, literacy, and language into consideration. [ABSTRACT FROM AUTHOR]

The co-occurrence of depression and chronic diseases is often under-recognized, under-treated, and under-studied. Among Latinos, complex structural and cultural barriers exist which complicate the translation of chronic disease self-management programs (CDSMP) for this population. To better understand those barriers and deliver a CDSMP designed to best meet local needs, a community-based, mixed methods study was designed. Formative research was conducted through focus groups with Latinos with chronic illness and minor depression (ICD) and family members to obtain insight into perceived needs and interviews with stakeholders to assess barriers and facilitators to the adoption of CDSMPs. Analytic Hierarchy Process was employed to determine core elements of a CDSMP for ICDs, family members, and the promotores who deliver these programs. Findings guided the transcreation of a CDSMP. This study offers a promising model for enhancing the effects of evidence-based interventions and emphasizes the importance of meeting differing needs within the local population. [ABSTRACT FROM AUTHOR]

Objective.To date, there is a paucity of research and information on Hispanic men cancer survivors (HMCS), who comprise part of the largest and fastest growing racial/ethnic minority group in the country. The purpose of this paper is to provide a deeper understanding of the supportive care needs of HMCS. Design.Three focus groups with a community sample of HMCS (n = 18) and interviews with providers (n = 5) were conducted to explore the supportive care needs of Hispanic men who had been diagnosed with cancer within the last five years. The data were analyzed using applied thematic analysis techniques. Results.Findings from focus groups and interviews are presented concurrently. The overarching themes that emerged were the need for: culturally sensitive cancer care and better communication with providers; cancer treatment-related information and comprehensive survivorship care; support and to connect with other cancer survivors and the need to negotiate changing gender role expectations and still provide for their family. Conclusion.Study findings contribute to the literature by presenting the supportive care needs of HMCS and illustrate the need for continued research to address disparities in access to cancer information and in the provision of culturally sensitive care. We provide recommendations and suggestions to address the supportive care needs of HMCS. [ABSTRACT FROM PUBLISHER]

Compared with non-Latino Whites, Latino immigrants have a lower prevalence of depression. However, they are also less likely to seek professional mental health services. Our objective was to compare and contrast perceptions of depression and access to mental health care among four of the largest Latino immigrant subgroups in Florida (Puerto Rican, Cuban, Mexican, and Colombian). We conducted a total of 120 interviews (30 men and women from each subgroup). Thematic analysis of qualitative data revealed that participants across the four groups were aware of the signs and symptoms of depression and had similar perceptions of depression. However, notable differences by subgroup emerged with regard to perceptions of access to mental health care. We suggest that the variation stems from differences in life experiences and the immigration context. Understanding the variances and nuances of Latino immigrants' cultural construction of depression and immigration experience will enable practitioners to better serve this community. [ABSTRACT FROM AUTHOR]

Cancer is the leading cause of death among Hispanics/Latinos, who represent the largest racial/ethnic minority group in the United States, accounting for 17.4% (55.4 million/318 million) of the total US population in 2014. Every 3 years, the American Cancer Society reports on cancer statistics for Hispanics based on incidence data from the National Cancer Institute, the Centers for Disease Control and Prevention, and the North American Association of Central Cancer Registries and mortality data from the National Center for Health Statistics. Among Hispanics in 2015, there will be an estimated 125,900 new cancer cases diagnosed and 37,800 cancer deaths. For all cancers combined, Hispanics have 20% lower incidence rates and 30% lower death rates compared with non-Hispanic whites (NHWs); however, death rates are slightly higher among Hispanics during adolescence (aged 15-19 years). Hispanic cancer rates vary by country of origin and are generally lowest in Mexicans, with the exception of infection-associated cancers. Liver cancer incidence rates in Hispanic men, which are twice those in NHW men, doubled from 1992 to 2012; however, rates in men aged younger than 50 years declined by 43% since 2003, perhaps a bellwether of future trends for this highly fatal cancer. Variations in cancer risk between Hispanics and NHWs, as well as between subpopulations, are driven by differences in exposure to cancer-causing infectious agents, rates of screening, and lifestyle patterns. Strategies for reducing cancer risk in Hispanic populations include increasing the uptake of preventive services (e.g., screening and vaccination) and targeted interventions to reduce obesity, tobacco use, and alcohol consumption. [ABSTRACT FROM AUTHOR]

Oral health care is critical for farmworkers' families in Central Florida. There is little research regarding the access to primary oral health care, barriers, and behaviors of Mexican migrant families. Forty semi-structured interviews were conducted with parents who are farmworkers in order to understand the factors that impact dental service utilization. Other factors that were also examined related to parental decisions regarding visits to the dentist with their children. This study highlights the inconsistent and inadequate patterns of dental health care services available for women, men, and children of farmworkers in Central Florida. [ABSTRACT FROM AUTHOR]

The Tampa Bay Community Cancer Network (TBCCN) is one of 25 Community Network Programs funded by the National Cancer Institute's (NCI's) Center to Reduce Cancer Health Disparities with the objectives to create a collaborative infrastructure of academic and community based organizations and to develop effective and sustainable interventions to reduce cancer health disparities. In order to describe the network characteristics of the TBCCN as part of our ongoing evaluation efforts, we conducted social network analysis surveys with our community partners in 2007 and 2008. One key finding showed that the mean trust value for the 20 community partners in the study increased from 1.8 to 2.1 (p<0.01), suggesting a trend toward increased trust in the network. These preliminary results suggest that TBCCN has led to greater collaboration among the community partners that were formed through its capacity-building and evidence-based dissemination activities for impacting cancer health disparities at the community level. © 2010 Wiley Periodicals, Inc. [ABSTRACT FROM AUTHOR]

Emerging adults discontinue behavioral health treatment at rates ranging from 30% to 50%. This study explored dropout using semi-structured interviews (N = 20). Participants were engaged in a group therapy program, Healthy Transitions. Findings revealed the lack of therapeutic relationship and logistical issues such as cost, transportation, and conflicting work schedules contributed to dropout. Participants indicated that alleviating logistical barriers and feeling a connection to their peers and group leader prevented dropout. This program was free, transportation was provided, and sessions were in the evening. Participants expressed peer educators made them feel less judged and/or stigmatized than a one-on-one therapy appointment. These findings reinforce logistical issues and lack of a therapeutic relationship contribute to dropout and highlight the benefits of flexible scheduling and reinforce the importance of a therapeutic relationship in preventing dropout. [ABSTRACT FROM AUTHOR]

Food security is a multidimensional concept consisting of food availability, access, utilization, and stability. However, food security is often measured as a single-dimensional construct with recent considerations for nutrition security. Using the multidimensional approach as a guiding framework, the purpose of this mixed methods study was to explore how emergency food assistance impacted food security among people seeking food assistance over time during the COVID-19 pandemic. Adults between ages 18 and 64, English-speaking, and Florida residents were recruited at emergency food distribution sites in West Central Florida. Participants completed initial (n=129) and follow-up (n=59) surveys with demographic questions, questions about food assistance use, and the Household Food Security Survey Module (HFSSM). Participants that were food insecure and sought food assistance prior to COVID-19 were invited to participate in two, in-depth interviews: one at baseline (n=18) and one after three months (n=16). Wilcoxon Signed Rank Test compared HFSSM scores at baseline and follow-up, and bivariate analysis examined associations for improved food security scores. Applied thematic analysis was conducted to identify emergent themes. Quantitative results showed improvement in HFSSM scores (higher food security) at follow-up (p < 0.001). The seven emergent themes described processes and challenges in which people experiencing food insecurity must manage to ensure their families have enough food (eg, frequency of pantry visits varied; juggling between food pantries, SNAP, and/or food purchasing; not all pantries are worth going to). Study findings show that the multidimensional approach to food security is promising to guide nuanced food security measurement. Quantitative and qualitative changes across each food security dimension reveal aspects that can be used to tailor programs to address specific needs in food availability, access, utilization, and stability over time. University of South Florida College of Public Health, Feeding Tampa Bay [ABSTRACT FROM AUTHOR]

Coping strategies (CS) to manage crises such as a pandemic or food insecurity (FI) are markers of resilience and potential protective factors that may support stability and promote individuals' well-being. The purpose of this study was to identify CS among people seeking emergency food assistance (EFA) during the COVID-19 pandemic and compare the strategies between people that sought assistance for the first time before or during the pandemic. Guided by the Transactional Model of Stress and Coping, in-depth interviews (n=36) were conducted to explore CS of participants seeking EFA at food distribution sites in West Central Florida between November 2020 and July 2021. Applied thematic analysis was conducted to identify emergent themes. Participants reported strategies such as reducing food purchasing, finding "helpful" pantries that provided preferred foods, meal-planning and freezing foods, seeking social support, and changing their mindset. Six emergent themes described their experiences coping with FI: (1) normalizing restricted food intake, (2) stretching food dollars, (3) realizing that pantries were an overrated safety net, (4) maximizing pantry food utilization, (5) experiencing FI with added pandemic and non-pandemic stressors, (6) envisioning a hopeful future post-COVID-19. A major difference between the two populations was that new visitors perceived their situation as temporary and things would be "back to normal" soon, whereas for "before COVID" participants, seeking EFA was a crucial, long-term solution that involved innovative strategies such as bartering and "food bank shopping" to ensure they never ran out of food. Together, these CS and themes describe how people seeking EFA actively manage multiple stressors to improve FI and financial stability. Study findings can inform interventions at EFA sites by incorporating concepts like motivational interviewing to support participants through stressful times. By identifying CS that may promote food security (eg, culinary skills and food assistance information seeking), people seeking EFA may be able to better utilize pantry foods to have sufficient and healthy food. University of South Florida College of Public Health; Feeding Tampa Bay [ABSTRACT FROM AUTHOR]